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Improving Drinking Water Quality Monitoring in Cambodia: Rethinking Performance Measurement

Explore the complexities of assessing water access and quality, challenges in monitoring progress, and the importance of public health considerations in Cambodia. Discusses various water supply sources, assessment stages, and ways to define progress effectively.

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Improving Drinking Water Quality Monitoring in Cambodia: Rethinking Performance Measurement

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  1. Re-thinking progress: Performance monitoring of drinking water quality in Cambodia Andrew Shantz Consultant for WHO-Cambodia shantz.andrew@gmail.com

  2. Summary Complexities of measuring access to water ‘Improved’ as an indicator for quality Historical performance monitoring data and future targets Comparison to point-of-consumption water quality Defining progress for the future

  3. Complexities • What components of water access do we actually want to assess? • Water quality? • Water quantity? • Water supply accessibility? • Water supply reliability? • What types of water usage are we interested in? • Drinking? • Domestic purposes? • Not always the same sources/supplies

  4. Complexities • What if >1 source/supply per household per year? • Wet season supplies • Dry season supplies • Primary / Secondary / Tertiary supplies • At what stage do we want to assess the water? • At the source (i.e. underground water, river, rainfall)? • Storage at the home (i.e. tank, jar, container)? • Point-of-consumption (i.e. post-treatment, drinking cup/glass)?

  5. Assessing water is complex! • Prioritize • Cannot assess and monitor everything • What is the focus of the decisions being made? • Public health? • Livelihoods/economics? • Infrastructure assessment? • What factors are most relevant to country context? • Think about what you truly want to understand • Define the question clearly • Work backwards to design the methodology to reach the answer

  6. JMP and ‘Improved’ Supplies • Improved supplies • Boreholes / tube wells • Improved dug wells • Piped water supplies • Rainwater harvesting • Unimproved supplies • Surface water • Unimproved dug wells • Vendor supplied water • Improved supplies ‘more likely’ to provide safe water • So…it is an indicator for quality

  7. 2014

  8. 2014

  9. What does the MDG indicator really mean? • Indicator for microbial water quality at the source • Not an indicator for… • Chemical water quality • Quantity • Reliability • Accessibility • Point-of-consumption  Public health?

  10. ‘Improved’ vs. Point-of-consumption • Progress on drinking water quality is apparent in rural Cambodia • 2015 MDG target already achieved • But what are the public health realities?

  11. POOR PROTECTION http://www.thehindu.com/news/national/karnataka/majority-of-rural-households-in-karnataka-use-unsafe-water-says-study/article2726480.ece

  12. UNHYGENIC STORAGE http://real-estate-malta.com/water-tanks-in-malta-how-to-clean/

  13. DIRTY HANDLING http://www.optimallyorganic.com/WaterDistiller.htm

  14. National assessment of microbial point-of-consumption water quality • 984 drinking water samples from the drinking glass • Representative of rural Cambodia • Representative of rainy season conditions

  15. National assessment of microbial point-of-consumption water quality • 84% of water samples came from Improved supplies • But only 23% met water quality standard for E. coli… • …and only 44% were considered lowrisk (<10 cfu) • Despite progress, public health issues remain

  16. Defining progress for the future • What do we really want to know? • How can performance monitoring shape decision-making? • What resources are available nationally? • But must think beyond JMP definitions to truly understand public health issues related to water

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